# The nurse in the outpatient orthopedic clinic is reviewing the medical records of several patients being...

###### Question:

The nurse in the outpatient orthopedic clinic is reviewing the medical records of several patients being seen in the clinic today. In the most recent note by the provider, the nurse reads the following:

“67-year-old, moderately obese woman examined today for increasing back and left shoulder pain. Limited circumduction of left arm noted in comparison with right arm. Strength of left arm is less than right, with less muscle definition in the left arm. Examination of back indicates significant kyphosis, and the patient states that she is ‘shrinking.’ Bone density testing of the hip is ordered.”

1. How does the nurse interpret “limited circumduction”?
2. When the patient arrives, the nurse correlates the “kyphosis” with what physical finding? What causes kyphosis in the older adult?
3. How should the nurse explain the patient’s decreasing height?
4. What is the rationale for ordering bone density testing of the hip in this patient?

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